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Learn about the most common sexual conditions affecting men and women. Cialis vs Viagra - What's the difference between them? Cialis and Viagra are both PDE5 inhibitors used for the treatment of erectile dysfunction (ED). Cialis lasts for around 36 hours compared with only 4 to 5 hours for Viagra. Food does not affect the activity of Cialis, whereas food may decrease the effectiveness of Viagra. Cialis can be used once daily, at a smaller dosage, and is also effective at treating benign prostatic hyperplasia (BPH). Dosage of Cialis may need to be reduced in men with liver or kidney problems and risk of interactions may be higher than with Viagra. What ingredients are contained in Cialis or Viagra and how do they work? Cialis is the brand name for tadalafil and Viagra is the brand name for sildenafil.

1,2 Both belong to a class of medicines known as phosphodiesterase type 5 (PDE5) inhibitors.

PDE5 inhibitors work only in the presence of sexual stimulation, as they rely on the natural release of nitric oxide (NO), a chemical only released during sexual arousal. NO in turn activates other substances to relax the smooth muscle inside the penis to allow the inflow of blood and an erection to occur. Which drug was first approved and which one lasts for longer? On March 27 th , 1998, Viagra became the first oral pill, and the first PDE5 inhibitor, to be approved by the FDA to treat ED.

4 A generic for Viagra was approved in March 2016 5 and released in December 2017. Cialis was first approved for ED on November 21st, 2003. 6 It was the third PDE5 inhibitor to come onto the market (after Levitra [vardenafil]). 7 Cialis has an advantage over Viagra and Levitra in that it lasts for a lot longer – 36 hours, compared with 4-5 hours for Viagra and Levitra. 1,2,7 A generic for Cialis was approved in May 2018 11 and released in September 2018.

How quickly do Cialis and Viagra work and does food have any effect. Cialis generally works within 16 to 45 minutes, and its activity is not affected by food. Viagra generally works within 30 minutes, and its effect may be diminished if taken soon after a high fat meal (which may also delay how fast it works). For this reason, Viagra is best taken on an empty stomach.

Effectiveness of all PDE5 inhibitors is similar; although reported effectiveness of Viagra, at 84% is slightly higher than that of Cialis at 81%.

7 However, more men prefer Cialis because of its longer duration of effect. Cialis can be taken on an as needed basis, or daily.

1 Generally, daily dosages are smaller than as needed doses. 8 Typically, Cialis is taken as a 10mg starting dose, prior to sexual activity. The dosage may be increased to 20mg if 10mg is ineffective or reduced to 5mg if side effects are intolerable. When Cialis is taken for daily use, the recommended initial dosage is 2.5mg once daily, or 5mg for people who also have BPH. Timing of the daily dosage does not matter in people using it solely for ED; however, those with BPH are advised to take it at the same time each day. Do not take more than one dose a day but your doctor may consider an increase in dosage from 2.5 to 5mg if ineffective.

Side effects of Cialis include headache and indigestion. Viagra is taken on an as needed basis, at a dose of 50mg, approximately 1 hour before sexual activity (although can be taken from 30 minutes to 4 hours before).

The dose may be increased to 100mg if 50mg is ineffective or decreased to 25mg if side effects are intolerable. 2 Viagra should only be taken once a day even though the effects wear off after approximately 4-5 hours.

The main side effects are headache, flushing and indigestion. 2 Rarely, color perception may be altered with Viagra. Cost of Viagra varies depending on tablet strength but is approximately $24 per tablet for the 50mg strength and $35 for the 100mg strength.

9 Cialis costs approximately $8.50 for the 5mg strength and $28 for the 20mg strength, per tablet. All PDE5 inhibitors are contraindicated with nitrates. 1,2 The longer duration of action of Cialis means it is at higher risk for drug interactions, 1 and dosages may need reducing in men with kidney or liver disease. Cialis is not recommended in men who have had a heart attack or stroke within the past 6 months, with either uncontrolled high blood pressure or severely low blood pressure, unstable angina, or other conditions that make sexual activity inadvisable.

Erections aren’t always easy for millions of men in the UK.

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Sildenafil is the active ingredient in both branded Viagra and generic Sildenafil tablets. Sildenafil and Viagra are PDE5 inhibitors, meaning they work by allowing blood vessels to expand and relax.

This increases the blood flow to the penis, making it easier to get – and maintain – an erection, thus improving sexual performance for men who are suffering from erectile dysfunction (ED). Sildenafil and Viagra work the same; they’re equally effective, require the same amount of time to take effect, and they work for the same duration. The main difference between Sildenafil and Viagra is the branding and the price. Viagra tablets inevitably cost more than the generic Sildenafil medication.

When researching your options for erectile dysfunction medications, the huge variety of brands on the market can be a pain to navigate.

Finding the right medication shouldn’t be a big deal – millions of men suffer with ED, and you’re simply looking for the best option. While there are other branded and generic types of ED medications available,

such

This is thanks to Viagra being the first solution widely available for assisting men with ED – not to mention its clever marketing over the years. As a result of becoming a household name, Viagra is expected to keep a 29% market share by 2022. The less-catchy name might give you reason to pause, but hear us out.

Like Viagra, Sildenafil has a high rate of success – whatever the underlying reasons behind your ED. In this article, we’ll try to give you the key info you need to choose between Viagra and Sildenafil.

What Are the Similarities Between Viagra and Sildenafil?

Plainly speaking, Sildenafil and Viagra are the same medication and contain the same active ingredient. Sildenafil is the generic or unbranded version, and Viagra is the globally famous “little blue pill” brand.

Though it may seem like Sildenafil is the newbie ED medication, there are no real solid reasons to prefer the more established Viagra product over Sildenafil. Sildenafil was invented back in the late 1980s by scientists working for American pharmaceutical company, Pfizer. The medication was initially developed to treat heart problems like angina, but was patented by Pfizer in 1998 as Viagra once they’d realised its potential as a licensed ED medication.

Pfizer’s patent for Viagra expired in 2012 for countries outside the US, and it expires completely in 2020. This means that generic forms of the same medication, known simply as Sildenafil, can enter the market.

Both drugs have the same amount of active ingredient (Sildenafil Citrate) in each comparable dose. In medical terms, this is known as bioequivalence . Importantly for you, this means the way both drugs work, how long they take to work, how well they work and how long they work for, are the same.

Despite its notoriety, Viagra is not “better” than Sildenafil or another branded product. They have the same effect on your ability to maintain an erection. Important note: The bioequivalence also means you need to steer clear of both Sildenafil and Viagra if you have been medically advised against taking either of them. Sildenafil and Viagra both work by inhibiting the PDE5 enzyme, which controls muscle contraction in

the

Viagra, Cialis, Levitra, and Stendra are oral medications used to treat erectile dysfunction (ED).

You may also know them by their generic names: sildenafil (Viagra) tadalafil (Cialis) vardenafil (Levitra) avanafil (Stendra) About 30 million American men occasionally have a problem with getting or keeping an erection, according to the Urology Care Foundation.

When ED becomes a problem, many men turn to these oral ED medications.

However, there are also some key differences, such as when you take them, how long they work, and what their side effects are.

Viagra, Cialis, Levitra, and Stendra are all in a class of drugs called PDE5 inhibitors. These drugs work by blocking an enzyme called phosphodiesterase type 5.

They also boost a chemical in your body called nitric oxide. This action encourages the muscles in your penis to relax. Relaxed muscles allow blood to flow freely so that when you’re aroused, you can get an erection. It also helps you maintain the erection long enough to have sex.

Here are the basic features of each of these drugs: Brand name Viagra Cialis Levitra Stendra What’s the generic name of this drug?

sildenafil tadalafil vardenafil avanafil Is a generic version available?

oral tablet oral tablet oral tablet oral tablet What strengths does it come in? 25 mg, 50 mg, 100 mg 2.5 mg, 5 mg, 10 mg, 20 mg 5 mg, 10 mg, 20 mg 50 mg, 100 mg, 200 mg What’s the typical dosage?

50 mg 10 mg (when used as needed); 2.5 mg (when

used

4 hours up to 36 hours 4-5 hours 6 hours How do I store it?

Around room temperature, between 68°F to 77°F (20°C to 25°C) At 25°C (77°F) At 25°C (77°F) Around room temperature, between 68°F to 77°F (20°C to 25°C) The drugs are available in a variety of doses, ranging from 2.5 milligrams (mg) to

200

Most of them stay in your bloodstream for about four to five hours.

Cialis is the exception, as it remains in your bloodstream for up to 36 hours. The length of time a drug stays in your system may be important if you’re taking

other

Viagra, Cialis, Levitra, and Stendra are usually stocked at most pharmacies. In general, most health insurance companies won’t cover their costs. However, if you have certain medical conditions, your health plan may pay for the drug with prior authorization. The exact price you pay for any drug will depend on your insurance plan and your pharmacy. Generic versions of Viagra, Cialis, Levitra can cost half as much as their brand-name counterparts, if not less.

The side effects of these medications are mostly similar. Below are the drugs’ most common side effects, according to their manufacturers: Side effect Viagra Cialis Levitra Stendra Stuffy or runny nose x x x x Headache x x x x Dizziness x x Upset stomach x x x Nausea x Indigestion x x Vision changes x Rash x Flushing x x x x Back pain x x x x Pain in the limbs x Muscle aches x x Sore throat x. Tell your doctor if you have any side effects that linger and don’t go away on their own. If you have an erection that lasts longer than four hours, call your doctor right away.

This condition, known as priapism, is a risk associated with all of these ED drugs. Unlike Viagra and the other PDE5 inhibitors, Cialis is also approved to treat enlarged prostate.

Both Viagra and Cialis can be taken 30 minutes before sexual activity.

However, Cialis lasts much longer and is noteworthy for the amount of time it remains in your body. You may feel the effects of the drug up to 36 hours after you take it.

The fact that it comes in a low-dose (2.5 mg) version also means that Cialis can be taken every day. A daily dose will ensure that the drug’s always in your system. This side effect isn’t associated with any other oral ED drugs. Viagra can take 30 to 60 minutes to work in the body, while Levitra takes 60 minutes.

Levitra does have fewer common side effects than Viagra, and it isn’t associated with a rash or muscle aches.

While vision

changes

The 100-mg and 200-mg doses can be taken as shortly as 15 minutes before sexual activity. As a second-generation medication, Stendra also seems to have milder side effects than Viagra and the other PDE5 inhibitors that came before it. Side effects commonly caused by Viagra — but not Stendra — include dizziness, vision changes, nausea, and muscle aches. The only buy generic viagra online no prescription common

side

Since PDE5 inhibitors work on the body in similar ways, Viagra, Cialis, Levitra, and Stendra lead to similar interactions.

All four of these drugs interact with: nitrates, such as isosorbide mononitrate (Monoket) and nitroglycerin (Nitrostat) certain blood pressure drugs, such as calcium channel blockers alpha blockers, which can treat high blood pressure or an enlarged prostate certain pulmonary hypertension drugs, such as riociguat (Adempas) protease inhibitors, a class of HIV drugs antifungal drugs, such as ketoconazole and itraconazole (Onmel, Sporanox) antibacterial drugs, such as clarithromycin (Biaxin) Drinking excessive amounts of alcohol while on any PDE5 inhibitor should be avoided, and you shouldn’t combine different ED drugs. Cialis may also be less effective if

used

Tell your doctor if you take other over-the-counter or prescription drugs or supplements.

Be sure to mention all other health conditions you have.

When used correctly, each of these drugs has been shown to help men with ED.

If you have questions or concerns, talk with your doctor.

All of them lead to good results, but it may take a little time and patience to get it right. If one drug doesn’t work or produces unpleasant side effects, you can try another drug.

It may also take some trial and error to find the dosage that works best for you.

If you’re not sure that drug treatment is right for you, you can also give natural ED treatments a try.

Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis.

Department of Urology,

The

Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000 Jiangxi Province China.

Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000 Jiangxi Province China.

Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000 Jiangxi Province China.

Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000 Jiangxi Province China. Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000 Jiangxi Province China. Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000 Jiangxi Province China. Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000 Jiangxi Province China.

Erectile dysfunction (ED) is a major care problem worldwide. Tadalafil and sildenafil are the two most common phosphodiesterase 5 inhibitors used to treat ED. This systematic review and meta-analysis were conducted to directly compare tadalafil with sildenafil for the treatment of ED.

We designed a strategy for searching the PubMed, Embase, EBSCO, Web of Science and Cochrane library databases; the reference lists of the retrieved studies were also investigated. A literature review was performed to identify all published randomized or non-randomized controlled trials that compared tadalafil with sildenafil for the treatment of ED and to assess the quality of the studies. Two investigators independently and blindly screened the studies for inclusion.

A total of 16 trials that compared tadalafil with sildenafil for the treatment of ED were included in the meta-analysis. In the meta-analysis, tadalafil and sildenafil appeared to have similar efficacies and overall adverse event rates.

However, compared with sildenafil, tadalafil significantly improved psychological outcomes.

Furthermore, the patients and their partners preferred tadalafil over sildenafil, and no significant difference was found in the adherence and persistence rates between tadalafil and sildenafil.

Additionally, the myalgia and back pain rates were higher and the flushing rate was lower with tadalafil than with sildenafil.

Tadalafil shares a similar efficacy and safety with sildenafil and significantly improves patients’ sexual confidence.

Furthermore, patients and their partners prefer tadalafil to sildenafil. Hence, tadalafil may be a better choice for ED treatment.

Erectile dysfunction (ED) is defined as the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse.

ED is one of the most common sexual dysfunctions, and an estimated 5–20% of men are affected by moderate to severe ED around the world [1]. The prevalence of ED is approximately 15.77% in southern India, 15.0–49.5% in China, 56.1% in Iran and 58.9% in south-western Nigeria [2–5]. The estimated global prevalence has been increasing, and approximately 322 million

men

Although ED is a benign disorder, it can affect physical and psychosocial health and may have a significant impact on the quality of life of patients and their partners.

Currently, several treatment strategies are available for patients with ED, including non-invasive and invasive options. Oral phosphodiesterase type 5 inhibitors (PDE5-Is) are the first-line therapy for ED [7].

PDE5-Is are similar to cyclic guanosine monophosphate (cGMP) in structure; thus, PED5-Is can bind to PDE5 competitively and inhibit cGMP hydrolysis, leading to a penile erection [8]. Four PDE5-Is (sildenafil, tadalafil, vardenafil and avanafil) are currently approved by the US FDA and have comparable efficacy and side effect profiles [9].

Sildenafil and tadalafil are the two most common phosphodiesterase inhibitors (PDEIs) around the world.

Sildenafil, the original PDEI, was introduced in 1998. Sildenafil has a quick onset of action of 30 min after the initial dose, a duration of action of 4–6 h and a maximum duration of 12 h [10].

Sildenafil is effective for the treatment of ED, although 20–50% of patients who respond to sildenafil discontinue its use [11]. Tadalafil is a selective, long-acting PDEI that was released in 2003. Tadalafil has an onset of 20 min and should be taken 30 min prior to intercourse; additionally, this drug has the longest duration of action in its class and a maximum duration of 72 h.

A total of 52% of patients can have successful intercourse within 30 min of taking tadalafil [12].

Recently, several systematic reviews and meta-analyses have comparatively analysed the role of PDEIs, including sildenafil and tadalafil, in the treatment of ED. However, because most of these review articles were indirect comparative analyses, the differences between sildenafil and tadalafil remain unclear [13–15].

Hence, this meta-analysis was conducted to directly compare sildenafil with tadalafil for the treatment of ED and to provide guidance for the clinical treatment of ED. In January 2017, the PubMed, EBSCO, Web of Science, Cochrane library and Embase databases were searched for randomized or non-randomized controlled clinic trials of sildenafil and tadalafil. The search was performed by combining the term “erectile dysfunction or sexual dysfunction” with the following words describing the drug: tadalafil or Cialis and sildenafil or Viagra.

We also searched for additional relevant studies by examining the reference lists of the selected papers and reviews.

The search process was not limited by language, country or year of publication.

For the present systematic review, randomized or non-randomized controlled trials that met the following criteria were included: (a) the study included a comparison between sildenafil and tadalafil; (b) the study provided accurate data that applied to a meta-analysis, including the International Index of Erectile Function (IIEF)-EF domain, preference and treatment–emergent adverse events (TEAEs); and (c) the full text of the study could be acquired.

When the same study was published in different journals or in different years, the most recent version was used for the meta-analysis. Abstracts, reviews and articles that did not contain accurate relevant data and a comparative analysis of sildenafil and tadalafil were

excluded

Two independent reviewers evaluated all identified publications, and any disagreement between reviewers was resolved by a third reviewer. The methodological quality was assessed using the Jadad score, with a Jadad score ?3 indicating a high-quality article [16]. Data extractions were performed by one reviewer and checked by a second reviewer. Information was extracted from the studies that met the above-mentioned inclusion criteria using a structured form. The first author, publication year, sample size, therapy that the patients received and assessment indices, including the IIEF, the men’s preference, the Self-Esteem and Relationship questionnaire (SEAR), total Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) scores and TEAEs, were collected for each study.